BACKGROUND
[0001] Embodiments of the inventive concept described herein relate to a customized surgical
guide, and a customized surgical guide producing method, and a producing program,
and more particularly, to a customized surgical guide, a customized surgical guide
producing method, and a producing program by which surgery is performed in accordance
with a state of a treatment target region of a specific patient during the specific
patient's surgery.
[0002] In surgery, medical staffs measure a region to be subjected to surgery based on medical
images. In this process, the region measurement is dependent on the surgeon's eye-based
measurement and experience. Thus, it may happen that a region to be removed is not
completely removed. Further, a region to be removed is not accurately measured such
that a large region than the region to be removed is cut off.
[0003] Further, a removal area on a skin surface is marked before surgery is performed.
However, when the surgery starts and the body portion is excised, a marker on the
surface of the skin may not match an inner portion to be removed, such that an accuracy
at which the scope of surgery within the body portion is determined is lowered. In
order to mark a certain point inside the body, an ultrasonic or mammography guide
H-wire is inserted to remove a corresponding body portion. This may have marking inaccuracy.
Further, this takes pain and long surgery time. Occasionally, a part of the H-wire
is cut off or left in the body during surgery.
SUMMARY
[0004] Embodiments of the inventive concept provide a customized surgical guide, and a customized
surgical guide producing method, and a producing program by which a removal region
in a body portion subjected to surgery is three-dimensionally displayed, and, thus,
accurate visual identification of the removal region (i.e., treatment target region)
is realized during the surgery of the removal region.
[0005] Further, embodiments of the inventive concept provide a customized surgical guide
produced based on a treatment plan that allows a medical instrument to reach a plurality
of target points within a body portion for treatment of the treatment target region
at a minimal treatment procedure, and a customized surgical guide producing method,
and a producing program.
[0006] The purposes to be achieved by the inventive concept are not limited to the purposes
mentioned above, and other purposes not mentioned may be clearly understood by those
skilled in the art from the following descriptions.
[0007] According to an exemplary embodiment, a customized surgical guide includes at least
one guide tube through which a medical instrument is insertable; and a body portion
cover covering a surface of a specific body portion, wherein the body portion cover
is coupled to the at least one guide tube. The body portion cover has a hole defined
therein through which the medical instrument passes. The medical instrument passes
through the guide tube and then through the hole toward the body portion. The body
portion cover is shaped to conform to a surface of the body portion of a patient.
The body portion cover defines a position of the guide tube such that the medical
instrument reaches a target point within the body portion. The guide tube has a larger
inner diameter than an outer diameter of the medical instrument. The guide tube has
a length sized such that an insertable depth of the medical instrument into the body
is limited to a set depth from a first point to the target point. The first point
is present on the surface of the body portion, and the guide tube is coupled to the
body portion cover at a position thereof corresponding to the first point. The target
point is present on a surface of or inside a treatment target region, or is spaced
by a specific distance from the treatment target region.
[0008] According to the inventive concept as defined above, following various effects may
be realized.
[0009] First, using the customized surgical guide that assists in performing patient-customized
surgery may allow optimal surgery for the patient. For example, when a to-be-removed
lesion (for example, tumor) within the affected portion should be removed, the patient-customized
surgical guide is used to produce at least one dye column in the body portion. The
dye column may be used to allow the medical staff to visually check the to-be-removed
region during surgery. Thus, the medical staff may remove a minimal tissue via two-or
three-dimensional marking using the dye column.
[0010] Second, since the guide tube is produced by calculating a depth to the target point
based on the medical image data, the medical staff may perform the surgery without
paying attention to the depth of insertion of the medical instrument, (for example,
syringe). In other words, when the medical instrument is fully inserted into the guide
tube of the customized surgery guide, the medical instrument reaches the target point,
so that the surgery can be easily performed.
[0011] Third, the body portion cover is shaped to conform to the body portion shape, and
the body portion cover defines a position of the guide tube such that the medical
instrument accurately reaches the target point within the body portion. This prevents
treatment from being performed on a wrong target point or prevents erroneously marking
in the body portion.
[0012] Fourth, even when there is a difference between a posture of the patient at which
the medical image data is obtained and a posture of the patient at which the surgery
is performed, the customized surgical guide may allow the medical instrument to accurately
reach the target point.
BRIEF DESCRIPTION OF THE FIGURES
[0013] The above and other objects and features will become apparent from the following
description with reference to the following figures, wherein like reference numerals
refer to like parts throughout the various figures unless otherwise specified, and
wherein:
FIG. 1 is a perspective view of a customized surgical guide according to one embodiment
of the inventive concept.
FIG. 2 is an illustration of a customized surgical guide attached to a body portion
according to one embodiment of the inventive concept.
FIG. 3 is an illustration of forming a dye column from a target point of a treatment
target region surface through a guide tube according to one embodiment of the inventive
concept.
FIG. 4 is a flowchart of a customized surgical guide producing method according to
one embodiment of the inventive concept.
FIG. 5 is a flowchart of a customized surgical guide producing method further including
calculating a position change of a treatment target region in a second posture using
first posture-based medical image data, according to one embodiment of the inventive
concept.
FIG. 6 is a flowchart of a customized surgical guide producing method further including
requesting injection based on last shape data according to one embodiment of the inventive
concept.
FIG. 7 is a flowchart illustrating a process of producing a body portion cover shape
covering an entire body portion according to one embodiment of the inventive concept.
DETAILED DESCRIPTION
[0014] A customized surgical guide according to one embodiment of the inventive concept
includes at least one guide tube through which a medical instrument is insertable;
and a body portion cover covering a surface of a specific body portion. The body portion
cover is coupled to the at least one guide tube. The body portion cover has a hole
defined therein through which the medical instrument passes. The medical instrument
passes through the guide tube and then through the hole toward the body portion. The
body portion cover is shaped to conform to a surface of the body portion of a patient.
The body portion cover defines a position of the guide tube such that the medical
instrument reaches a target point within the body portion. The guide tube has a larger
inner diameter than an outer diameter of the medical instrument. The guide tube has
a length sized such that an insertable depth of the medical instrument into the body
is limited to a set depth from a first point to the target point. The first point
is present on the surface of the body portion, and the guide tube is coupled to the
body portion cover at a position thereof corresponding to the first point. The target
point is present on a surface of or inside a treatment target region, or is spaced
by a specific distance from the treatment target region.
[0015] Further, when the medical instrument is a syringe with a specific needle length,
the guide tube may be formed so that the syringe needle reaches the target point,
and the target point may be a specific point on a surface of the treatment target
region in the body portion. While the syringe is removed away from the target point
through the guide tube, the syringe may supply dye to form a dye column in the body
portion.
[0016] Further, when the medical instrument performs treatment on a treatment range defined
as a specific range from a specific point which the inserted medical instrument reaches,
the target point may be at least one specific point located within the treatment target
region, and the at least one specific point may define at least one treatment range
covering the treatment target region. A number of the guide tubes may be equal to
a number of the target points, and each guide tube may be formed on the first point
of the body portion cover and extends in a direction from the first point toward each
target point.
[0017] Further, the body portion cover may be formed to conform to body surface acquired
based on medical image data. The guide tube may have a length set based on a distance
on the medical image data from the first point on the body surface to the target point
that the medical instrument should reach.
[0018] Further, the customized surgical guide may be made of deformable material and may
be inserted using a laparoscope into the body and then be placed on the body portion
surface.
[0019] Further, when the body portion including the treatment target region has a shape
varying according to a posture of the patient, the body portion cover may cover the
body portion and may fix a shape of the body portion into a specific shape.
[0020] Further, when a distal end of the medical instrument reaches the target point, the
guide tube may be fitted with the medical instrument.
[0021] A method of producing a customized surgical guide according to another embodiment
of the inventive concept, the guide including a guide tube through which a medical
instrument is inserted, and a body portion cover contacting a body surface, includes
acquiring, by a computer, body surface data and treatment region data from medical
image data; generating, by the computer, first shape data based on the body surface
data, the first shape data defining a shape of the body portion cover; setting, by
the computer, at least one target point, the target point being present on a surface
of or inside a treatment target region; setting, by the computer, each first point
on the body surface from which the medical instrument is accessible to the target
point; setting, by the computer, a length of the guide tube based on a distance from
the first point to the target point; and applying, by the computer, the guide tube
length to the first point to generate last shape data as a combination between the
first shape data and shape data of at least one guide tube.
[0022] Further, when the medical instrument is a syringe with a specific needle length,
the target point may be a specific point on a surface of the treatment target region
in the body portion. While the syringe may be removed away from the target point through
the guide tube, the syringe may supply dye to form a dye column in the body portion.
[0023] Further, when the medical instrument performs treatment on a treatment range defined
as a specific range from a specific point which the inserted medical instrument reaches,
the target point may be at least one specific point located within the treatment target
region. The setting of the at least one target point may include setting at least
one target point to define at least one treatment range covering the treatment target
region.
[0024] Further, the generating of the first shape data may include: obtaining entire shape
data of the body portion; and generating shape data of the body portion cover covering
a specific body portion based on the entire shape data. The body portion cover may
cover the body portion and fixes a shape of the body portion into a specific shape.
[0025] Further, when a first posture of a patient at which the medical image data is taken
and a second posture of the patient at which surgery is performed are different, the
method may further include calculating a positional change of the treatment target
region when a posture of the patient changes from the first posture to the second
posture. The setting of the at least one target point, the setting of each first point,
and the setting of the length of the guide tube may be performed based on the changed
position of the treatment target region.
[0026] Further, the setting of the first point may include setting the first point from
which the medical instrument reaches the target point without passing through the
treatment target region.
[0027] Further, when the medical instrument is curved at a specific curvature, the setting
of the first point may include setting the first point from which the medical instrument
reaches the target point while moving along a curved path having the specific curvature
within the body. The generating of the last shape data may include generating curvature
data of the guide tube equal to the curvature of the medical instrument.
[0028] A customized surgical guide producing program according to still another embodiment
of the inventive concept may be stored in a medium for carrying out the customized
surgical guide producing method in combination with a computer as hardware.
[0029] Hereinafter, preferred embodiments of the inventive concept will be described in
detail with reference to the accompanying drawings. Advantages and features of the
inventive concept, and methods of accomplishing the same, will become apparent with
reference to the embodiments described in detail below with reference to the accompanying
drawings. However, the inventive concept is not limited to the embodiments disclosed
below, but may be embodied in various forms. These embodiments are provided so that
the disclosure of the inventive concept is complete and that it is believed that the
disclosure is intended to be completely understood by those skilled in the art to
which the inventive concept belongs. The inventive concept is only defined by the
scope of the claim. Like reference numerals refer to like elements throughout the
specification.
[0030] Unless otherwise defined, all terms including technical and scientific terms used
herein have the same meaning as commonly understood by one of ordinary skill in the
art to which this inventive concept belongs. It will be further understood that terms,
such as those defined in commonly used dictionaries, should be interpreted as having
a meaning that is consistent with their meaning in the context of the relevant art
and will not be interpreted in an idealized or overly formal sense unless expressly
so defined herein.
[0031] The terminology used herein is for the purpose of describing particular embodiments
only and is not intended to be limiting of the present disclosure. As used herein,
the singular forms "a" and "an" are intended to include the plural forms as well,
unless the context clearly indicates otherwise. It will be further understood that
the terms "comprises", "comprising", "includes", and "including" when used in this
specification, specify the presence of the stated features, integers, operations,
elements, and/or components, but do not preclude the presence or addition of one or
more other features, integers, operations, elements, components, and/or portions thereof.
[0032] As used herein, a term "computer" includes all of various devices that can perform
computational processing and present the results visually to the user. For example,
the computer may include a desktop PC, a notebook, a smartphone, a tablet PC, a cellular
phone, a PCS phone (Personal Communication Service phone), synchronous/asynchronous
IMT-2000 (International Mobile Telecommunication-2000) mobile terminal, a palm personal
computer, personal digital assistant (PDA), and so on. Further, a computer may be
a medical device that acquires or observes an angiographic image.
[0033] As used herein, a term "medical image data" means image data obtained by medical
imaging devices such as Computed Tomography (CT) device, MRI (Magnetic Resonance Imaging)
device or the like.
[0034] As used herein, a term "treatment target region" refers to a region to be treated
within a specific body portion. For example, in patients with breast cancer, the treatment
target region corresponds to a tumor region in the breast as the body portion. The
treatment target region may coincide with an affected region or may be actually larger
than the affected region with considering an error range.
[0035] As used herein, a term "medical instrument" refers to a tool which is used for surgery,
treatment, or examination, and is inserted or invaded into the body. For example,
the medical instrument may be a syringe with a needle of a specific length. Further,
for example, the medical instrument may be a device that is inserted into a specific
body portion and applies electrical stimulation to a specific range.
[0036] As used herein, a term "target point" refers to a point reached by the medical instrument
inserted through a customized surgical guide. In other words, the target point means
a point of maximum depth reached by the medical instrument while movement of the medical
instrument is limited by the guide tube. The target point may be a point located on
the surface of or interior in the treatment target region, or a point separated by
a certain distance from the treatment target region.
[0037] As used herein, a term "first point" refers to a point on the body portion surface
from which the medical instrument is inserted to reach the target point. That is,
the first point refers to the point on the body portion surface where the guide tube
is placed when placing a customized surgical guide in the body portion.
[0038] Hereinafter, a customized surgical guide, a customized surgical guide producing method
and a producing program according to embodiments of the inventive concept will be
described in detail.
[0039] FIG. 1 is an illustration of a customized surgical guide 10 according to one embodiment
of the inventive concept.
[0040] Referring to FIG. 1, the customized surgical guide 10 according to one embodiment
of the inventive concept includes a guide tube 100 and a body portion cover 200.
[0041] The guide tube 100 refers to a tube into which a medical instrument can be inserted.
The guide tube 100 has a larger diameter than that of a portion of the medical instrument
that is inserted into the body. Since the portion of the medical instrument is inserted
into the body, it may be dangerous when the portion of the medical instrument contacts
a wall surface of the guide tube 100 and thus foreign matter is attached to the portion
of the medical instrument. Therefore, the guide tube 100 has a larger diameter than
that of the portion of the medical instrument such that the portion of the medical
instrument is not in contact with the wall surface of the guide tube 100. For example,
when the medical instrument is a syringe with a needle, the guide tube 100 has a larger
diameter than that of the needle, and supports the syringe body and is oriented to
an orientation of the syringe body such that the needle is inserted at an accurate
angle. The guide tube 100 is formed with a length that limits a depth at which the
medical instrument can be inserted into the body to a set depth from the first point
to a target point 40. For example, when the medical instrument is a syringe with a
needle, the guide tube 100 is formed such that the needle is inserted into the guide
tube 100 and then the syringe is stopped by the guide tube 100 so that the needle
enters the body only at a certain depth. For example, when the length of the needle
is A, and the length of the guide tube 100 is B, the needle enters the body only as
long as a length corresponding to "A - B" as the syringe is stopped by the guide tube
100. Thus, the guide tube 100 of the customized surgical guide 10 limits the depth
at which the medical instrument is inserted into the body.
[0042] The length of the guide tube 100 is set based on a distance from the first point
on the body surface to the target point 40 which the medical instrument should reach,
on the medical image data. In one embodiment, when the customized surgical guide 10
is injected by a 3D printer, the computer analyzes a CT image or MRI image to calculate
the distance from the specific first point on the surface of the body portion to the
specific target point 40. Thereafter, the length of the guide tube 100 is calculated
by subtracting the calculated distance from the length (for example, the length of
the syringe needle) of the medical instrument used during the surgery. This allows
the computer to set the length of the guide tube 100 of the customized surgical guide
10 based on the patient's treatment target region 20.
[0043] The customized surgical guide 10 according to one embodiment of the inventive concept
has a number of guide tubes 100 corresponding to the number of target points 40 in
the body. Since each guide tube 100 is produced to have a length and direction to
reach from the first point to the target point 40, the number of the guide tubes 100
as produced may correspond to the number of the target points 40.
[0044] The body portion cover 200 is coupled to at least one guide tube 100, as in FIG.
1. That is, the body portion cover 200 has a hole defined therein through which the
medical instrument inserted through the guide tube 100 passes toward the body portion.
In this way, the medical instrument inserted through the guide tube 100 is invaded
or inserted into the body portion along an extension of the guide tube 100.
[0045] The body portion cover 200 covers a surface of a specific body portion. Specifically,
the body portion cover 200 is formed to conform to the surface of the body portion
of the patient. In one embodiment, the body portion cover 200 is produced based on
body surface data obtained based on the medical image data. For example, when the
body portion cover 200 is injected using a 3D printer and the breast of a breast cancer
patient is set as a body portion, shape data of the body portion cover 200 conforming
to a surface of the patient's breast shape in capturing the MRI image or CT image
is produced based on the MRI image or the CT image. Thus, the body portion cover 200
conforms to the body portion surface. Thus, when the medical instrument is inserted
into the guide tube 100 of the customized surgical guide 10 produced based on the
medical image data, the medical instrument reaches the target point 40 in the body
portion accurately. That is, the body portion cover 200 allows the guide tube 100
to be positioned at the first point set in a treatment planning process based on the
medical image data.
[0046] Further, in another embodiment, the customized surgical guide 10 includes a reference
point 300 for precise positioning of the customized surgical guide 10 when applied
to the patient, as shown in FIG. 2. The reference point 300 corresponds to a specific
location of the body portion to allow the customized surgical guide 10 to be placed
at the exact location set in the surgery planning or modeling. For example, when the
body portion is a breast, the customized surgical guide 10 has a hole with the same
size as a nipple at a point corresponding to the nipple. Thus, the accurate attachment
position is set on the body portion surface while the nipple is set as the reference
point 300.
[0047] In yet another embodiment, when a body portion including the treatment target region
20 has a shape changing depending on a posture of the patient, the body portion cover
200 of the customized surgical guide 10 covers the body portion and fixes the body
portion into a specific shape. For example, when the body portion is the breast, a
shape of the breast may change depending on a posture of the patient. Therefore, when
the breast has the same shape at the breast shape in setting the target point 40 based
on the medical image data, the medical instrument can reach the target point 40 through
the customized surgical guide 10 accurately. Accordingly, the body portion cover 200
may be formed to cover the entire body portion, and thus to deform and retain the
body portion into and as a shape obtained at imaging of the medical image data. For
example, when the body portion is a breast, the body portion cover 200 may be made
in the same shape as a brassiere, and may be worn on the patient during breast cancer
surgery.
[0048] The customized surgical guide 10 according to one embodiment of the inventive concept
may be implemented in various forms according to use purposes and may be used in various
ways. In one embodiment, when the medical instrument is a syringe with a specific
needle length, the guide tube 100 is formed such that the syringe needle reaches the
target point 40. In this connection, the target point 40 is the specific point on
the surface of the treatment target region 20 in the body portion. That is, the customized
surgical guide 10 is formed such that the specific point on a surface of the treatment
target region 20 (the specific point on an interface between the treatment target
region 20 and a normal region) is the target point 40. The plurality of target points
40 may be indicated as points on a plane corresponding to the interface between the
treatment target region 20 and normal region or may be indicated as a plurality of
points on the three-dimensional space of the treatment target region 20 having a three-dimensional
shape.
[0049] Specifically, as shown in FIG. 3, a syringe filled with a dye is inserted through
the customized surgical guide 10 to a distal end thereof to reach the target point
40. While the syringe is removed out of the guide, the dye is slightly discharged
from the syringe to dye an inside of the body portion. Thus, a dye column 30 is formed
to extend from the target point 40 in the body portion to the first point of the body
portion surface.
[0050] Forming a plurality of dye columns 30 through each guide tube 100 of the customized
surgical guide 10 may allow an accurate to-be-removed region (that is, treatment target
region 20) to be grasped. Even when the medical team cuts away the affected portion,
the dye column 30 is continuously present from the target point 40. Thus, the point
corresponding to the boundary of the treatment target region 20 may be confirmed in
the surgical procedure.
[0051] Further, in another embodiment, when the medical instrument is of a tool for performing
treatment while setting, as a treatment range, a specific range from a specific point
which the medical instrument reaches, the target point 40 is at least one specific
point located within the treatment target region 20 to form at least one treatment
range that encompasses the treatment target region 20. That is, the target point 40
reached by the medical instrument through the guide tube 100 becomes a specific point
within the treatment target region 20, while the medical instrument treats the treatment
range centered on the target point 40 by providing electricity thereto.
[0052] In this connection, the number of the guide tubes 100 corresponds to the number of
the target points 40. Each of the number of the guide tubes 100 is formed on the first
point of the body portion cover 200 and extends in a direction from the first point
toward the target point 40. When the treatment target region 20 is larger than the
treatment range, the customized surgical guide 10 includes a specific number of guide
tubes 100 such that treatment ranges formed around target points 40 of the guide tubes
100 respectively may overlap to cover the treatment target region 20. Thus, the surgeon
can perform the surgery simply by inserting the medical instrument(s) into the guide
tubes 100 which respectively guide the medical instrument to the target points 40
set according to the patient surgery plan.
[0053] Further, in another embodiment, the customized surgical guide 10 is formed of a deformable
material, and is inserted using a laparoscope into the body, and then placed on the
body portion surface. The customized surgical guide 10 may be placed on an internal
organ surface that is not exposed to the outside. To this end, the customized surgical
guide 10 is made of a material that can be deformed in shape and is inserted to a
specific body portion inside the body using the laparoscope while the guide is folded
or wound.
[0054] Further, in another embodiment, the guide tube 100 may be fitted with the medical
instrument when a distal end of the medical instrument reaches the target point 40.
This allows the medical staff to recognize that the medical instrument has reached
the target point 40. For example, a body of the guide tube 100 may be formed with
a first diameter that allows only the needle to enter thereto, while the distal end
of the guide tube 100 has a second diameter that conforms to the syringe tip. As the
syringe tip is fitted in the second diameter portion of the guide tube 100 and no
longer enters the body of the guide tube 100 having the first diameter. Thus, the
medical staff may recognize that the target point 40 has been reached by the medical
instrument. Further, when a medical instrument must apply stimulation, for example,
electrical stimulation to the target point 40 for a duration longer than or equal
to a specific time, the fitting between the guide tube 100 and the medical instrument
maintains a state in which the medical instrument reaches the target point 40 and
is fixed thereto.
[0055] FIG. 4 is a flowchart of a producing method of a customized surgical guide 10 according
to one embodiment of the inventive concept.
[0056] Referring to FIG. 4, a producing method of a customized surgical guide 10 according
to one embodiment of the inventive concept may include operation S100 in which a computer
acquires body surface data and treatment region data from medical image data; first
shape data generating operation S300 in which the first shape data is generated based
on the body surface data by the computer, wherein the first shape data is data corresponding
to a shape of the body portion cover 200; target point setting operation S500 in which
at least one target point 40 is set by the computer, wherein the target point 40 is
a point corresponding to the interior or surface of the treatment target region 20;
operation S700 in which each first point on the body surface is set by the computer,
wherein the medical instrument is accessible from the first point to the target point
40; operation S900 in which a length of the guide tube 100 is set by the computer
based on a distance from the first point to the target point 40; and operation S1100
in which last shape data is generated by the computer by applying the length of the
guide tube 100 to the first point, wherein the last shape data include a combination
of shape data of at least one guide tube 100 and the first shape data. Hereinafter,
a detailed description of each operation will be described.
[0057] The computer acquires body surface data and treatment region data from medical image
data (S100). That is, the computer obtains the medical image data of the specific
patient (for example, the MR image of the patient), and obtains, from the medical
image data, the body surface data for forming the body portion cover 200 and the treatment
region data corresponding to the treatment target region 20. Specifically, when the
treatment target region 20 is a tumor, the computer extracts the tumor region from
the medical image data.
[0058] The computer produces the first shape data based on the body surface data (S300:
first shape data generating operation). The first shape data is data corresponding
to the shape of the body portion cover 200. That is, the computer performs 3D modeling
into the shape corresponding to the patient's affected surface. Thus, the customized
surgical guide 10 having the body portion cover 200 that fits in the body portion
of the patient may be manufactured.
[0059] Further, the computer sets, as the reference point 300, a point on the first shape
data corresponding to a specific point on the body surface data. For example, when
the body part to be treated (that is, the affected portion) is the breast, the computer
forms a nipple hole 300 based on the nipple position on the body surface data. Thus,
the computer may use the nipple hole 300 as a reference when positioning the customized
surgical guide 10 on the body portion surface.
[0060] Further, in another embodiment, as in FIG. 7, the first shape data generating operation
S300 includes operation S310 for obtaining the entire shape data of the body portion;
and operation S320 for producing a shape of the body portion cover 200 covering the
specific body portion based on the entire shape data. When the body portion has a
shape changing according to the posture of the patient, for example, the body portion
is a breast, the body portion cover should be formed to cover the entire body portion,
and thus to deform and retain the body portion into and as a shape obtained at imaging
of the medical image data, thereby to perform precise surgery using the customized
surgical guide 10 as produced based on the medical image data. Thus, the computer
acquires the entire shape of the body portion from the medical image data, and then
models the body portion cover 200 into a shape covering the entire body portion.
[0061] For example, an MR imaging of the breast of a breast cancer patient is performed
while the patient lies down at a state in which her face faces downwardly, whereas
a breast cancer tumor removal surgery is performed while the patient lies down at
a state in which her face faces upwardly. Because the shape of the breast changes
due to the difference between the posture in the MR image and the posture in the surgery,
the tumor position inside the breast may change. Thus, to accurately mark the tumor
region inside the body via dying, the breast shape should be fixed and maintained
to and as the breast shape obtained at the imaging of the medical image data during
surgery. Therefore, the computer models the cover into the shape covering the entire
breast, and produces the cover via injection. Then, the body portion cover 200 is
placed on the breast and fixes and maintains the breast shape into that obtained at
the imaging of the medical image data during surgery.
[0062] The computer sets at least one target point 40 (S500: target point setting operation).
The target point 40 is the point corresponding to the interior or surface of the treatment
target region 20. Specifically, the computer models the treatment target region 20
(that is, the to-be-removed region) based on the calculated target region (for example,
the tumor region) with considering the error range. The computer then extracts at
least one point in and on the treatment target region 2 as the target point 40.
[0063] In one embodiment, when the medical instrument is a syringe with a specific needle
length, the target point 40 is set to the specific point on the surface of the treatment
target region 20. That is, the target point 40 is the point on a boundary face defining
a tissue to be removed via surgical surgery (that is, the tumor tissue).
[0064] Further, in another embodiment, when the medical instrument is a tool that performs
treatment while a treatment range is set to a specific range around a point of a specific
depth which the medical instrument reaches, the target point 40 is a specific point
within the treatment target region 20. In the target point setting operation S500,
the computer sets at least one target point 40 to define at least one treatment region
covering the treatment target region 20. That is, the computer extracts a plurality
of a specific medical instrument-based treatment ranges capable of covering the treatment
target region 20 and extract multiple target points 40 defining the treatment ranges
respectively which the medical instrument should reach.
[0065] The computer sets each first point on the body surface, wherein the medical instrument
is accessible from the first point to the target point 40 (S700: first point set operation).
For example, when the treatment target region 20 is a tumor region, the computer determines
the position (that is, the three-dimensional position) on the body portion surface
from which the needle may be injected toward a boundary of the tumor region.
[0066] Further, when the target point 40 is set to a point in the boundary between the treatment
target region 20 and the normal tissue region, the computer sets a first point from
which the medical instrument reaches the target point 40 without passing through the
treatment target region 20. For example, when the treatment target region 20 is a
tumor region, and when a medical instrument (such as a syringe needle) is inserted
from the skin surface through the tumor region to reach the target point 40, the tumor
region is damaged, such that cancer cells may be transferred to other body portions.
Thus, the computer extracts the first point from which the medical instrument reaches
the target point 40 without penetrating the treatment target region 20. To this end,
when the target point 40 is located deeply within the body in the treatment target
region 20, the computer sets the first point from which the medical instrument is
accessible to the target point 40 in a lateral direction.
[0067] Further, the computer sets an orientation angle of the guide tube 100 according to
the position of the first point set in association with the target point 40. For example,
when the medical instrument has a straight line shape, the guide tube 100 is oriented
in a direction of an extension of a straight line connecting the target point 40 and
the first point. Thus, when the medical staff merely inserts the medical instrument
into the guide tube 100, the medical instrument may reach the target point 40.
[0068] The computer sets the length of the guide tube 100 based on the distance from the
first point to the target point 40 (S900: guide tube 100 length setting operation).
The computer forms the guide tube 100 having a length such that a depth at which the
medical instrument can be inserted into the body is limited to a set depth from the
first point to the target point 40. For example, when the medical instrument is a
syringe with a needle, the guide tube 100 is formed such that the needle is inserted
into the guide tube 100 sand then the syringe is stopped by the guide tube 100 so
that the needle can only enter the body by the specific depth. That is, when the length
of the needle is A, and the length of the guide tube 100 is B, the needle enters the
body only as long as the length corresponding to "A - B" as the syringe is stopped
by the guide tube 100. Therefore, the computer sets the length of the guide tube 100
to a value calculated based on the length of the medical instrument and the distance
between the target point 40 and the first point (that is, to the difference between
the length of the medical instrument and the distance between the target point 40
and the first point).
[0069] The computer applies the length of the guide tube 100 to the first point to generate
the last shape data as combination of shape data of at least one guide tube 100 with
the first shape data (S1100: last shape data generating operation). That is, the computer
generates the last shape data as the combination between the shape data of at least
one guide tube 100 and the shape data of the body portion cover 200. The last shape
data indicates that the guide tube 100 having a specific length and orientation is
coupled to the body portion cover 200 at a specific position thereof. In other words,
the computer adjusts and models the length of each of the columns of the guide tubes
100 so that the needle can reach the boundary of the tumor region accurately when
the needle is inserted through each of the guide tubes.
[0070] The guide tube 100 of the customized surgical guide 10 as thus-formed performs various
roles. In one embodiment, when the medical instrument is a syringe with a specific
needle length, the guide tube 100 serves to assist in producing the dye column 30
in the body when the syringe supplies a dye into the body while the syringe is removed
away from the target point after the syringe needle reaches the target point 40. Further,
in another embodiment, the guide tube 100 plays a role in raising the accuracy of
the surgery by allowing the medical instrument to reach precisely the target point
40 to be treated based on the surgery plan.
[0071] Further, in another embodiment, as shown in FIG. 5, when a first posture of the patient
at which the medical image data is taken is different from a second posture of the
patient at which surgery is performed, the method further includes operation S200
for calculating the positional change of the treatment target region 20 when the posture
changes from the first posture to the second posture. When the medical image data
is taken at a posture at which surgery is performed, the customized surgical guide
10 may be modelled based on the medical image data. However, there may be cases where
a posture taken for imaging a medical image and a posture taken for surgery are different.
In this case, in order to produce the customized surgical guide 10 corresponding to
the second posture taken at the time of surgery, that is, in order to produce a customized
surgical guide 10 that corresponds to the second posture for the surgery based on
the medical image data taken at the first posture, the computer calculates the positional
change of the treatment target region 20 when the posture of the body portion of the
patient changes from the first posture to the second posture.
[0072] For example, among the body portions, the breast changes the shape thereof flexibly
according to the posture of the patient. The MR image is taken at the first posture
in which the patient lies down with her face facing downwardly, whereas the surgery
is performed at the second posture in which the patient lies down with her face facing
upwardly. Therefore, the breast shape may vary between the MR image capture and the
surgery. As the breast shape changes, a position of the tumor tissue in the breast
in the three-dimensional space may vary. Therefore, the computer identifies the breast
shape in the second posture based on the size of the breast, and the breast shape
in the first posture, and calculates the position of the tumor in the breast shape
in the second posture (that is, calculates the position of the treatment target region
20).
[0073] Further, when a medical image is taken at the first posture and then the customized
surgical guide 10 corresponding to the second posture is modeled, the target point
setting operation S500, the first point setting operation S700, and the guide tube
length setting operation S900 may be performed based on the changed position of the
treatment target region 20.
[0074] In yet another embodiment, the first shape data generating operation S300 calculates
the shape of the body portion in the second posture based on the medical image data
obtained in the first posture, and models the shape data of the body portion cover
200 (that is, the first shape data) based on the calculated shape data.
[0075] Further, in another embodiment of the inventive concept, where the medical instrument
is curved at a specific curvature, the computer produces the guide tube 100 at the
same curvature as that of the medical instrument. A straight line shaped medical instrument
may have difficulty in reaching the target point 40 in the body. In this case, the
curved medical instrument may be used. In order to insert the curved medical instrument
having a specific curvature through the customized surgical guide 10 into the body,
the guide tube 100 must be made at the same curvature as that of the medical instrument
and be smoothly inserted. Thus, on the medical plan, the medical instrument may reach
the accurate target point 40.
[0076] Further, in order to model the guide tube 100 into which a bent curved medical instrument
is inserted, the first point setting operation 700 extracts the first point from which
the medical instrument reaches the target point 40 while moving inside the body along
a curved path. That is, the computer extracts not a first point from which the medical
instrument reaches the target point 40 when moving along a straight-line path, but
a first point from which the medical instrument reaches the target point 40 when moving
along a specific curvature-based path.
[0077] Further, the last shape data generating operation S1100 generates the curvature of
the guide tube 100 equal to the curvature of the medical instrument. The last shape
data generating operation S1100 calculate the curve length of the guide tube 100 by
subtracting, from the medical instrument length, the distance by which the medical
instrument should travel along the curved path in the body.
[0078] Further, as shown in FIG. 6, another embodiment of the inventive concept further
includes operation S1200 for requesting injection of the surgical guide corresponding
to the last shape data. That is, the computer requests injection of the guide corresponding
to the modeled last shape data to a 3D injection device, that is, a 3D printer.
[0079] The above-described method of producing the customized surgical guide 10 according
to one embodiment of the inventive concept as described may be implemented using a
program (or application) to be executed in combination with a computer as hardware,
which may be stored in a medium.
[0080] The above-mentioned program may include codes encoded in a computer language such
as C, C ++, JAVA, or machine language which the computer's processor (CPU) can read
via a device interface of the computer. Thus, when the computer reads and executes
the program, the program may perform the method. These codes may include functional
codes related to functions that define necessary functions to execute the method,
or may include executable procedure-related control codes necessary for the processor
of the computer to execute the functions in accordance with a predetermined procedure.
Further, these codes may further include memory reference-related code that indicates
where additional information or media needed for the execution of the functions by
the computer's processor is addressed to any location (address) in the computer's
internal or external memory. Further, when the computer's processor needs to communicate
with any other computer or server at a remote location to execute the functions, the
codes may further include communication related codes indicating, for example, how
to communicate with any other computer or server remotely using a communication module
of the computer, and what information or media as transmitted or received therebetween
during communication.
[0081] The storage medium is not a medium for storing data for a short time such as a register,
a cache, a memory, etc., but means a medium that semi-permanently stores data and
is capable of being read by a device. Specifically, examples of the storage medium
include, but are not limited to, ROM, RAM, CD-ROM, magnetic tape, floppy disk, optical
data storage, and the like. That is, the program may be stored on various recording
media on various servers that the computer can access, or on various recording media
on the user's computer. Further, the medium may store therein computer readable codes
as distributed over a networked computer system and as read by the computer in a distributed
manner.
[0082] According to the inventive concept as defined above, following various effects may
be realized.
[0083] First, using the customized surgical guide 10 that assists in performing patient-customized
surgery may allow optimal surgery for the patient. For example, when a to-be-removed
lesion (for example, tumor) within the affected portion should be removed, the patient-customized
surgical guide 10 is used to produce at least one dye column 30 in the body portion.
The dye column may be used to allow the medical staff to visually check the to-be-removed
region during surgery. Thus, the medical staff may remove a minimal tissue via two-or
three-dimensional marking using the dye column 30.
[0084] Second, since the guide tube 100 is produced by calculating a depth to the target
point 40 based on the medical image data, the medical staff may perform the surgery
without paying attention to the depth of insertion of the medical instrument, (for
example, syringe). In other words, when the medical instrument is fully inserted into
the guide tube 100 of the customized surgery guide, the medical instrument reaches
the target point 40, so that the surgery can be easily performed.
[0085] Third, the body portion cover 200 is shaped to conform to the body portion shape,
and the body portion cover 200 defines a position of the guide tube such that the
medical instrument accurately reaches the target point 40 within the body portion.
This prevents treatment from being performed on a wrong target point 40 or prevents
erroneously marking in the body portion.
[0086] Fourth, even when there is a difference between a posture of the patient at which
the medical image data is obtained and a posture of the patient at which the surgery
is performed, the customized surgical guide 10 may allow the medical instrument to
accurately reach the target point.
[0087] While the inventive concept has been described with reference to exemplary embodiments,
it will be apparent to those skilled in the art that various changes and modifications
may be made without departing from the spirit and scope of the inventive concept.
Therefore, it should be understood that the above embodiments are not limiting, but
illustrative.
1. A customized surgical guide comprising:
at least one guide tube through which a medical instrument is insertable; and
a body portion cover covering a surface of a specific body portion, wherein the body
portion cover is coupled to the at least one guide tube, wherein the body portion
cover has a hole through which the medical instrument passes, wherein the medical
instrument passes through the guide tube and then through the hole toward the body
portion,
wherein the body portion cover is shaped to conform to a surface of the body portion
of a patient, wherein the body portion cover defines a position of the guide tube
such that the medical instrument reaches a target point within the body portion,
wherein the guide tube has a larger inner diameter than an outer diameter of the medical
instrument, wherein the guide tube has a length sized such that an insertable depth
of the medical instrument into the body is limited to a set depth from a first point
to the target point,
wherein the first point is present on the surface of the body portion, and the guide
tube is coupled to the body portion cover at a position thereof corresponding to the
first point,
wherein the target point is present on a surface of or inside a treatment target region,
or is spaced by a specific distance from the treatment target region.
2. The customized surgical guide of claim 1, wherein when the medical instrument is a
syringe with a specific needle length, the guide tube is formed so that the syringe
needle reaches the target point, wherein the target point is a specific point on a
surface of the treatment target region in the body portion, wherein while the syringe
is removed away from the target point through the guide tube, the syringe supplies
dye to form a dye column in the body portion.
3. The customized surgical guide of claim 1, wherein when the medical instrument is configured
to perform treatment on a treatment range defined as a specific range from a specific
point which the inserted medical instrument reaches, the target point is at least
one specific point located within the treatment target region, wherein the at least
one specific point defines at least one treatment range covering the treatment target
region, wherein a number of the guide tubes is equal to a number of the target points,
wherein each guide tube is formed on the first point of the body portion cover and
extends in a direction from the first point toward each target point.
4. The customized surgical guide of claim 1, wherein the body portion cover is formed
to conform to body surface acquired based on medical image data, and wherein the guide
tube has a length set based on a distance on the medical image data from the first
point on the body surface to the target point that the medical instrument should reach.
5. The customized surgical guide of claim 1, wherein the customized surgical guide is
made of deformable material and is inserted using a laparoscope into the body and
then is placed on the body portion surface.
6. The customized surgical guide of claim 1, wherein when the body portion including
the treatment target region has a shape varying according to a posture of the patient,
the body portion cover covers the body portion and fixes a shape of the body portion
into a specific shape.
7. The customized surgical guide of claim 1, wherein when a distal end of the medical
instrument reaches the target point, the guide tube is fitted with the medical instrument.
8. A method of producing a customized surgical guide, the guide including a guide tube
through which a medical instrument is inserted, and a body portion cover contacting
a body surface, the method comprising:
acquiring, by a computer, body surface data and treatment region data from medical
image data;
generating, by the computer, first shape data based on the body surface data, the
first shape data defining a shape of the body portion cover;
setting, by the computer, at least one target point, the target point being present
on a surface of or inside a treatment target region;
setting, by the computer, each first point on the body surface from which the medical
instrument is accessible to the target point;
setting, by the computer, a length of the guide tube based on a distance from the
first point to the target point; and
applying, by the computer, the guide tube length to the first point to generate last
shape data as a combination between the first shape data and shape data of at least
one guide tube.
9. The method of claim 8, wherein when the medical instrument is a syringe with a specific
needle length, the target point is a specific point on a surface of the treatment
target region in the body portion, wherein while the syringe is removed away from
the target point through the guide tube, the syringe supplies dye to form a dye column
in the body portion.
10. The method of claim 8, wherein when the medical instrument is configured to perform
treatment on a treatment range defined as a specific range from a specific point which
the inserted medical instrument reaches, the target point is at least one specific
point located within the treatment target region, wherein the setting of the at least
one target point includes setting at least one target point to define at least one
treatment range covering the treatment target region.
11. The method of claim 8, wherein the generating of the first shape data includes:
obtaining entire shape data of the body portion; and
generating shape data of the body portion cover covering a specific body portion based
on the entire shape data,
wherein the body portion cover covers the body portion and fixes a shape of the body
portion into a specific shape.
12. The method of claim 8, wherein when a first posture of a patient at which the medical
image data is taken and a second posture of the patient at which surgery is performed
are different, the method further comprises calculating a positional change of the
treatment target region when a posture of the patient changes from the first posture
to the second posture,
wherein the setting of the at least one target point, the setting of each first point,
and the setting of the length of the guide tube are performed based on the changed
position of the treatment target region.
13. The method of claim 9, wherein the setting of the first point includes setting the
first point from which the medical instrument reaches the target point without passing
through the treatment target region.
14. The method of claim 8, wherein when the medical instrument is curved at a specific
curvature, the setting of the first point includes setting the first point from which
the medical instrument reaches the target point while moving along a curved path having
the specific curvature within the body,
wherein the generating of the last shape data includes generating curvature data of
the guide tube equal to the curvature of the medical instrument.
15. A customized surgical guide producing program stored in a medium for carrying out
the method of one of claims 8 to 14 in combination with a computer as hardware.